mental illness or mental health…

When do the normal ups and downs of daily life become bipolar disorder? When does eating too much chocolate because it was a bad day become binge eating? Or the regular onset of nerves before speaking in public a mixed anxiety depression?  The fifth edition of the bible of all psychiatrists, the Diagnostic and Statistical Manual of Mental Disorders is soon to be published. Edition four introduced conditions such as Attention Deficit Hyperactive Disorder (ADHD) which saw sales of the drug Ritalin flourish – no doubt with substantial profits for Novartis. It begs the questions ‘What will be the medication of choice for this new batch of disorders?’

A definition of mental health is required, but which one? Spot the differences.

  • Health Education Authority (1997) “the emotional and spiritual resilience which enables us to survive pain, disappointment and sadness. It is a fundamental belief in our own and others’ dignity and worth”.
  • World Health Organisation (2007) “Mental health is a state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community.”
  • Mind (2010) A level of emotional well-being that allows an individual to function in society or an absence of significant mental health problems.

Foucault wrote about docile bodies which were inscribed with cultural categories of dysfunction. Negative identities permitted state regulation. One particularly pernicious category for 19th century women was hysteria. The Yellow Wallpaper offers a chilling insight into how post natal depression was misconstrued according to the norms of the time.  In the days of the Victorian lunatic asylum, attributions of insanity endowed the power to incarcerate and remove from society. As well as the changes in language, cultural responses have changed too, along with the ever increasing breadth of diagnostic conditions. Any new classification of mental illness serves to legitimise intervention. With categories becoming ever more closely aligned to the trials and tribulations of 21st century life, it seems likely that those set to gain the most benefit from these latest additions to the manual, are most probably the pharmaceutical companies themselves.

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